Ultrafine Particle Concentrations in a Hospital.

Ultrafine particles (UFP) may contribute to the morbidity and mortality associated with exposure to ambient particles, but few data are available on ultrafine particle numbers in indoor air, where susceptible subjects spend most of their time. We measured particle number, UFP size distribution, and total suspended particulate (JSP) mass in three locations: (I) a medical floor in a large tertiary care hospital, (2) outdoor air above a construction site outside the hospital, and (3) an environmental exposure chamber with purification of intake air. Mass and number concentrations were recorded continuously in each location over 70-110 h. Mean ± SD particle (p) numbers were 3.63 ± 1.l5 } 10(3) p/cm(3) in the hospital, 3.05 ± 6.65 } 10(4) p/cm(3) outside, and 5.86 ± 2.11 } 10(2) p/cm(3) in the environmental chamber. In the hospital, particle number and mass declined during the evening hours when the unit was less active, with the particle number as low as 1.15 } 10(3) p/cm(3). Particle numbers peaked (2.78 } 10(4) p/cm(3)) in the morning hours when activity on the unit was the most intense. "Spikes" in fine particle number were often not accompanied by increases in TSP mass. In the hospital, a distinct population of ultrafine particles (median diameter approximately 23 nm) was observed during the lunch hour, suggesting a change in particle source during this time. Outdoor fine particle numbers above the construction site were highly variable, reaching peaks of greater than 1.7 } 10(6) p/cm(3). These data suggest that, in the indoor environment, particle numbers and size distribution vary with intensity and type of local activity, and significant peaks in particle number are not detected with daily averages. Monitoring of particle mass may be an inaccurate measure of exposure to ultrafine particles indoors.

Quantitative exposure of humans to an octamethylcyclotetrasiloxane (D4) vapor.

There is potential for human exposure to cyclic siloxanes by the respiratory route. To determine the pharmacokinetics of octamethylcyclotetrasiloxane (D4), a material commonly found in personal care products, the respiratory intake and uptake of D4 were measured in 12 healthy volunteers (25-49 years) on two occasions. Subjects inhaled 10 ppm D4 (122 micrograms/liter) or air (control) during a 1-h exposure via a mouthpiece in a double-blind, randomized fashion. Inspiratory and expiratory D4 concentrations were continuously measured. Exhaled air and plasma D4 levels were measured before, during, and after exposures. Individual D4 uptakes were measured under steady-state conditions during three rest periods (10, 20, and 10 min, respectively) alternating with two 10-min exercise periods. Mean D4 intake was 137 +/- 25 mg (SD) and the mean deposition efficiency was equivalent to 0.74/(1 + 0.45 VE), where VE is the minute ventilation. No changes in lung function were induced by the D4 vapor. Plasma measurements of D4 gave a mean peak value of 79 +/- 5 ng/g (SEM) and indicated a rapid nonlinear blood clearance. Using lung volume and respiratory surface area estimates based on functional residual capacity measurements, we developed a model and determined that the effective mass transfer coefficient for D4 was 5.7 x 10(-5) cm/s from lung air to blood. In an additional eight subjects, we compared D4 deposition with mouthpiece and nasal breathing at resting ventilations. For these individuals, mean deposition was similar for the two exposure protocols, averaging 12% after correction for exposure system losses. These are the first data describing the intake and absorption of D4 and they should contribute to a meaningful safety assessment of the compound.

Sulfuric acid aerosol followed by ozone exposure in healthy and asthmatic subjects.

These studies evaluated symptom and pulmonary function responses of humans sequentially exposed to sulfuric acid aerosol and ozone. Thirty healthy subjects and 30 allergic asthmatic subjects underwent 3-hr exposures in an environmental chamber to 100 micrograms/m3 sulfuric acid and sodium chloride (control) aerosols (in random order), followed 24 hr later by 3-hr exposures to ozone (0.08, 0.12, or 0.18 ppm). Each subject was studied four times, receiving each aerosol preexposure followed by two of the three ozone concentrations. For the healthy group, no convincing symptomatic or physiologic effects of exposure to either the aerosol or ozone on lung function were found. For the asthmatic group, preexposure to sulfuric acid altered the pattern of response to ozone in comparison with sodium chloride preexposure and appeared to enhance the small mean decrements in FVC that occurred in response to 0.18 ppm ozone (means +/- SE: -3.6 +/- 1.5% with sodium chloride preexposure, -6.8 +/- 1.7% with sulfuric acid preexposure). Individual responses among asthmatic subjects were quite variable, some demonstrating reductions in FEV1 of more than 35% following ozone exposure. Analysis of variance of changes in FVC revealed evidence for interactions between aerosol and ozone exposure both immediately after (P = 0.005) and 4 hr after (P = 0.030) exposure. Similar effects were seen for FEV1. When normal and asthmatic subjects were combined, four-way analysis of variance revealed an interaction between ozone and aerosol for the entire group (P = 0.0022) and a difference between normal and asthmatic subjects (P = 0.0048). There was no significant effect of exposures on symptoms for either normal or asthmatic subjects. Asthmatic subjects differ from healthy volunteers in their functional responses following sequential exposures to aerosols and ozone and appear to represent a susceptible population.

Oxidant and acid aerosol exposure in healthy subjects and subjects with asthma. Part II: Effects of sequential sulfuric acid and ozone exposures on the pulmonary function of healthy subjects and subjects with asthma.

These studies were undertaken to evaluate pulmonary responses of humans sequentially exposed to acidic aerosols and ozone at levels that could reasonably be encountered in actual environmental exposures. Subjects first were exposed to sulfuric acid (H2SO4) aerosol to sensitize the airways to ozone. The exposure protocols were designed to provide more quantitative information about the threshold levels of ozone that produce adverse biological effects and to provide exposure-response data on ozone. Two groups of 30 nonsmoking volunteers of both sexes, between the ages of 18 and 45 years, were recruited. The healthy study population comprised 16 men and 14 women with an average age of 28 years and no airway hyperreactivity. The second group comprised 10 men and 20 women comparable in age to the control group, but with allergic asthma and positive skin tests. The study examined an exposure-response relationship using three levels of ozone ranging from below the current standard to one and one-half times the ambient air quality standard (0.08, 0.12, and 0.18 ppm* [parts per million]) with preexposure 24 hours earlier to H2SO4 (100 micrograms/m3) or sodium chloride (NaCl) (control) aerosol in a 45-m3 environmental chamber. The study used an incomplete block design in which each subject was exposed to four of the six paired experimental atmospheres. Both the selection of paired exposures and the order in which they were presented were randomized. The exposure protocol required nine days: Day 1, training and baseline preexposure measurements; Day 2, the first of the three-hour particle (H2SO4 or NaCl) exposures; Day 3 (24 hours after Day 2), ozone exposure at 0.08, 0.12, or 0.18 ppm for three hours; Day 4 (two to four weeks later), exposure to the same ozone concentration as on Day 4. After at least another two weeks, Days 6, 7, 8, and 9 repeated Days 2, 3, 4, and 5 using a second ozone concentration. All three-hour exposures included several predetermined periods of exercise and pulmonary function measurements. To examine for delayed effects, pulmonary function tests were measured two and four hours after exposure on the ozone days. Data were analyzed over the time course of exposure and by exposure level of ozone at each time point to reveal dose-response relationships more closely. The main findings of the study are as follows. No significant symptomatic or physiologic effects of exposure to either aerosol or ozone on lung function were found for the healthy group.(ABSTRACT TRUNCATED AT 400 WORDS)

Pulmonary performance of elderly normal subjects and subjects with chronic obstructive pulmonary disease exposed to 0.3 ppm nitrogen dioxide.

Symptoms and changes in pulmonary function of subjects with chronic obstructive pulmonary disease (COPD) and elderly normal subjects, induced by a 4-h exposure to 0.3 ppm NO2, were investigated using a double-blind, crossover design with purified air. The 5-day experimental protocol required approximately 2 wk with at least a 5-day separation between randomized 4-h exposures to either NO2 or air which included several periods of exercise. Over a 2-yr period, COPD subjects, all with a history of smoking, consisting of 13 men and 7 women (mean age of 60.0 yr) and 20 elderly normal subjects of comparable age and sex were evaluated. During intermittent light exercise, COPD subjects demonstrated progressive decrements in FVC and FEV1 compared with baseline with 0.3 ppm NO2, but not with air. Differences in percent changes from baseline data (air-NO2) showed an equivocal reduction in FVC by repeated measures of analysis of variance and cross-over t tests (p less than 0.10). Subgroup analyses suggested that responsiveness to NO2 decreased with severity of COPD; in elderly normal subjects, NO2-induced reduction in FEV1 was greater among smokers than never-smokers. A comparison of COPD and elderly normal subjects also revealed distinctions in NO2-induced responsiveness.

Effects of nitrogen dioxide exposure on pulmonary function and airway reactivity in normal humans.

Nitrogen dioxide (NO2) is a product of combustion that has become recognized as a significant component of indoor air in some homes. Despite extensive study, it remains unresolved whether exposures to low levels of NO2 affect airway function or reactivity. These studies were designed to assess effects of various levels and patterns of NO2 exposure on pulmonary function and airway reactivity in normal humans. Normal volunteers screened for the absence of airway hyperreactivity were exposed for 3 h in an environmental chamber to purified air or NO2, separated by at least 2 wk, according to three protocols: (1) continuous 0.60 ppm NO2, (2) baseline 0.05 ppm NO2 with intermittent peaks of 2.0 ppm, and (3) continuous 1.5 ppm NO2. Subjects exercised for 10 min of each 30 min at a level sufficient to result in a minute ventilation near 40 L/min. Pulmonary function was measured before, during, and after exposure. Airway reactivity to increasing doses of carbachol was assessed 30 min after exposure. NO2 did not directly alter pulmonary function in any of the exposure protocols. In addition, airway reactivity was not altered by continuous exposure to 0.60 ppm or intermittent peaks of 2.0 ppm NO2. In contrast, continuous exposure to 1.5 ppm NO2 resulted in a greater fall in FVC and FEV1 in response to carbachol than after exposure to air (percent decrease in FVC: 1.5% after air, 3.9% after NO2, p less than 0.01). We conclude that for subjects without airway hyperreactivity, exposure to 1.5 ppm NO2 for 3 h increases airway reactivity, whereas repeated 15-min exposures to 2.0 ppm NO2 do not alter airway reactivity.

Effects of in vitro exposure to nitrogen dioxide on human alveolar macrophage release of neutrophil chemotactic factor and interleukin-1.

To evaluate the potential toxic and immunologic effects of nitrogen dioxide (NO2) exposure on cells from the lower respiratory tract, normal human alveolar macrophages obtained by bronchoalveolar lavage were exposed to increasing concentrations of NO2 using an in vitro exposure system. Alveolar macrophages exposed to 5, 10, or 15 ppm NO2 for 3 hr showed no difference in cell viability when compared to air-exposed macrophages. In addition, the spontaneous release of neutrophil chemotactic factor (NCF) was not changed by NO2 exposure, nor was there any effect on the ability of alveolar macrophages to release increased amounts of NCF following stimulation with activated zymosan. Furthermore, alveolar macrophages did not spontaneously release interleukin-1 (IL-1) following air or NO2 exposure. When stimulated with influenza virus both air- and NO2-exposed cells released increased amount of IL-1, but was no significant difference in the amount of IL-1 released by air- and NO2-exposed alveolar macrophages. Thus, although NO2 exposure is known to incite an inflammatory response in the lower respiratory tract, using the in vitro exposure system described in this study we were unable to demonstrate a direct toxic effect of NO2 on viability or any NO2-induced change in the release of the immunoregulatory molecules NCF and IL-1.

Inhalation of 0.30 ppm nitrogen dioxide potentiates exercise-induced bronchospasm in asthmatics.

Epidemiologic studies support an association among elevated levels of nitrogen dioxide (NO2), increased respiratory symptoms, and alterations in lung function. To determine if low level NO2 inhalation potentiates exercise-induced bronchospasm, 15 asthmatic subjects, defined by airway constriction with cold air provocation, inhaled 0.30 ppm (560 micrograms/m3) NO2 for 30 min. All asthmatics inhaled either air or 0.30 ppm NO2 via a mouthpiece for 20 min at rest followed by 10 min of exercise on a bicycle ergometer at a workload of 300 kpm/min, producing a 3-fold or greater increase in minute ventilation. Our studies showed 72 +/- 2 (SE)% deposition of inhaled NO2 at rest and 87 +/- 1% deposition with exercise (p less than 0.001). Nitrogen dioxide inhalation at rest resulted in no significant change in pulmonary function. Nitrogen dioxide inhalation plus exercise compared to control (air) exposure plus exercise produced significantly greater reductions in FEV (p less than 0.01) and partial expiratory flow rates at 60% of total lung capacity (p less than 0.05). One hour after completion of NO2 exposure and exercise, pulmonary function had returned to baseline values. To determine if NO2 exposure caused increased reactivity to a known bronchoconstrictor, asthmatic subjects inhaled cold air (range: -11 +/- 2 degrees C) at 3 successive rates of isocapnic ventilation. The response to cold air was expressed as the respiratory heat exchange required to reduce the FEV by 10% (PD10RHE). Prior NO2 exposure potentiated the fall in FEV, PD10RHE, and specific airway conductance (p less than 0.05) after isocapnic cold air hyperventilation, compared to the control exposure.(ABSTRACT TRUNCATED AT 250 WORDS)

Prediction of kidney mercury content by isotope techniques.

A 61-year-old female patient accidentally aspirated liquid mercury during a medically ordered diagnostic procedure. To develop animal-based guidelines, liquid mercury was introduced into the lungs of four dogs. Based on the study of these animals, a method of predicting the kidney inorganic mercury burden was developed using radioactive isotope dilution techniques. It was further demonstrated in dogs that oral administration of dimercaptopropane sulfonate (DMPS) increased mercury excretion and reduced the kidney burden. A rat experiment was performed permitting a statistical evaluation of the assumptions basic to the use of the method. The method was applied to the patient with the result that the kidney inorganic mercury burden was predicted to be 28.1 mg, 8 months after the accident. Treatment with DMPS increased urinary excretion and the post-treatment kidney burden was estimated at 19.6 mg Hg. Inasmuch as the radioactive dose to the subject may be kept at a negligible level and because sensitive methods exist for measurement of radioactive and stable mercury concentrations, the technique may be applicable in special cases to the estimation of kidney inorganic mercury burdens incurred by industrial exposure.

Pulmonary retention of neutron-activated coal dust.

Coal dust aerosols with cesium-134 and scandium-46 labels were studied in dogs and rats following brief inhalation exposures by external measurement of gamma photons in the 0.6 to 0.8 and 0.9 to 1.1 MeV regions, respectively. Ancillary in vitro studies of the leaching characteristics of the two radionuclides from coal were made and control studies utilizing the "free" radionuclides were undertaken for each of the investigations with radioactive coal dust. The biological data strongly infer that coal dust retention in canine lungs is extremely protracted with a biological half-life no shorter than approximately 4.3 yr and probably much longer. The biological model which was formulated and analyzed to obtain this finding is discussed along with its limitations.

Airway reactivity to nitrates in normal and mild asthmatic subjects.

Epidemiologic studies have reported increased symptoms in young asthmatics when atmospheric pollutants containing nitrates and sulfates are elevated. To determine if inorganic nitrate pollutants cause increased airway reactivity in humans, 10 normal volunteers and 11 mild asthmatics inhaled a sodium nitrate (NaNO3) aerosol with an aerodynamic diameter of 0.46 micron at a concentration of 7,000 microgram/m3, a level 100--1,000 times greater than reported urban levels for nitrates. A sodium chloride (NaCl) aerosol of similar characteristics served as a control. By double-blind randomization, each subject breathed NaCl or NaNO3 for a 16-min period and again 2--4 h later. Deposition studies showed 32--78% retention of the inhaled aerosol. Functional residual capacity, airway resistance, forced vital capacity, 1-s forced expiratory volume, and maximum and partial expiratory flow rates at 60 and 40% of total lung capacity did not significantly change during or after exposure. All subjects remained asymptomatic. To establish if aerosol exposure increased reactivity to a known bronchoconstrictor, subjects inhaled 0.025--1.0% carbachol following the 16-min exposure. Although prior inhalation of NaNO3 or NaCl aerosols did not significantly alter the effect of carbachol on pulmonary function, two asthmatics demonstrated mild potentiation of the carbachol bronchoconstrictor response after nitrate exposure. These results suggest that in normal subjects and mild asthmatics short-term NaNO3 exposure does not alter pulmonary function.

Studies of the lymphatic drainage of dog lungs.

The lymphatic system of the lungs has proved difficult to study and characterize because it is technically complex to investigate, its properties are difficult to quantitate, and anatomically it is extraordinarily variable. This study was part of a more comprehensive effort to understand the nature of lymphatic permeation by extrinsic materials (e.g., dusts) arising from alveolar deposition, and had three main objectives; (1) to develop a reliable surgical approach for the collection of lymph from the right duct; (2) to investigate some of the inconsistencies in lymphatic structure and function, especially the relationship of the right lymph duct (RLD) and thoracic lymph duct (TLD) outflows to the pulmonic lymph; and (3) to begin a systematic investigation of lymphatic uptake of administered materials by varying their physicochemical parameters. Ultimately, we utilized a modification of the surgical approach of Meyer, which we believe is less prone to blood contamination than the venous-sac procedure of Leeds and Uhley and provides purer pulmonic lymph. By this means we obtained average RLD flow rates of 4.5 ml/h or 0.35 ml/h . kg body weight in 24 dogs, which are comparable to those in the recent literature. For demarcation of the pulmonic drainage in relation to the RLD and TLD, we found in 13 dogs that 75% or more of the lung lymph returned to the venous circulation through the RLD, wheras less than 3% of the thoracic lymph entered the RLD. Radioactive tracers were administered by intralymphatic, intrabronchial, inhalation, and intravenous routes to obtain these findings and the uptake data. Lymphatic uptake values for iron, cadmium, and lead were obtained principally after intrabronchial administration. The uptake data, while preliminary, indicate that both the chemical species and their physical states are important in affecting alveolar permeation into the pulmonic lymph. Evidence for varying lymphatic roles in the alveolar retention of these heavy metals is also presented.

Pulmonary retention and translocation of insufflated tantalum.

Studies of pylmonary clearance of tantalum dust labeled with 182Ta in dogs have been extended to as far as 816 days postexposure in order to substantiate earlier pulmonary retention data, examine lymphatic uptake, and seek long-term pathological changes. Exposure to 5-mug and 10-mug powders was compared with the results of earlier 1-mug studies. The 2.1-year long-term clearance half-time of 1-mug powder was confirmed, while the 5-mug and 10-mug powders were found to have a mean long-term retention half-time of 333 days. All three particle sizes demonstrated rapid postinsufflation uptake by the pulmonary lymph nodes, followed by either retention or very slow clearance. No tantalum-induced pathological changes were found on histological examination.